Gürkan AKGÖL1, Hasan ULUSOY2, Selda TELO3, Arif GÜLKESEN1, Tülay YILDIRIM4, Ahmet Kürşad POYRAZ5, Arzu KAYA1

1Department of Physical Medicine and Rehabilitation, Medical Faculty of Fırat University, Elazığ, Turkey
2Department of Rheumatology, Medicana International Samsun Hospital, Samsun, Turkey
3Department of Biochemistry and Clinical Biochemistry, Medical Faculty of Fırat University, Elazığ, Turkey
4Department of Physical Medicine and Rehabilitation, Medical Faculty of İnonü University, Malatya, Turkey
5Department of Radiology, Medical Faculty of Fırat University, Elazığ, Turkey

Keywords: 4-hydroxynonenal, disease activity, modified Larsen score, rheumatoid arthritis


Objectives: This study aims to evaluate serum 4-hydroxynonenal (4-HNE) levels and its clinical and radiological significance in patients with rheumatoid arthritis (RA).
Patients and methods: The study included 40 patients (8 males, 32 females; mean age 51.4±11.2 years; range 24 to 72 years) with RA and 30 healthy controls (8 males, 32 females; mean age 53.0±11.7 years; range 24 to 72 years. Serum 4-HNE levels were measured using sandwich enzyme-linked immunosorbent assay method. Patients with disease activity score 28 ≤3.2 and >3.2 were allocated into low and high/moderate disease activity groups, respectively. Additionally, patients were divided into two groups as early RA (disease duration ≤2 years) and established RA (disease duration ≥2 years). Functional disability was evaluated using health assessment questionnaire. Radiographs were scored using the modified Larsen scoring.
Results: Serum 4-HNE levels in patients with RA were significantly higher than controls (p=0.001). Serum 4-HNE levels did not correlate with laboratory or clinical parameters of disease activity including erythrocyte sedimentation rate, C-reactive protein, disease activity score 28, and health assessment questionnaire. Serum 4-HNE levels were higher in patients with established RA than patients with early RA (r=0.487, p=0.001). Besides, modified Larsen score which indicates structural damage correlated significantly with serum 4-HNE levels (p=0.001).
Conclusion: These results indicate that serum 4-HNE levels may be used as an indicator for structural damage such as erosions in the early stage of RA; however, they are not efficient to monitor disease activity.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.